0001505952-23-000041.txt : 20230405 0001505952-23-000041.hdr.sgml : 20230405 20230405161149 ACCESSION NUMBER: 0001505952-23-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230403 FILED AS OF DATE: 20230405 DATE AS OF CHANGE: 20230405 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jolley David R CENTRAL INDEX KEY: 0001972400 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38553 FILM NUMBER: 23802663 MAIL ADDRESS: STREET 1: C/O DOMO, INC. STREET 2: 722 EAST UTAH VALLEY DRIVE CITY: AMERICAN FORK STATE: UT ZIP: 84003 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DOMO, INC. CENTRAL INDEX KEY: 0001505952 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 273687433 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 BUSINESS ADDRESS: STREET 1: 772 EAST UTAH VALLEY DRIVE CITY: AMERICAN FORK STATE: UT ZIP: 84003 BUSINESS PHONE: 801-899-1000 MAIL ADDRESS: STREET 1: 772 EAST UTAH VALLEY DRIVE CITY: AMERICAN FORK STATE: UT ZIP: 84003 FORMER COMPANY: FORMER CONFORMED NAME: LIGHTSTORM, INC. DATE OF NAME CHANGE: 20110425 FORMER COMPANY: FORMER CONFORMED NAME: SHACHO, INC. DATE OF NAME CHANGE: 20101117 4 1 wf-form4_168072549620984.xml FORM 4 X0407 4 2023-04-03 0 0001505952 DOMO, INC. DOMO 0001972400 Jolley David R 772 EAST UTAH VALLEY DR. AMERICAN FORK UT 84003 0 1 0 0 Chief Financial Officer 0 Class B Common Stock 2023-04-03 4 A 0 225000 0 A 225000 D The shares are represented by restricted stock units ("RSUs"). Each RSU represents the Reporting Person's right to receive one share of Class B Common Stock of the Issuer, subject to the applicable vesting schedule. In the event the Reporting Person ceases to be a Service Provider, the unvested RSUs will be cancelled by the Issuer. /s/ Adam Gerulat, as attorney-in-fact 2023-04-05